A text-book on diseases of the ear, nose and throat . ere is usually a free discharge ofmuco-pus and a cessation of pain,Paracentesis-knife. especially after prompt spontaneous opening of the membrane. If thishas not occurred and paracentesis has been obligatory, the inspissatedsecretions escape more slowly at first and the pain gradually any form of perforation of the membrana in acute otitis mediaa discharge must be regarded as beneficial, as it carries off pathogenicgerms. Therefore little or no local treatment of the ear should be ap-plied for fear of secondary irritation
A text-book on diseases of the ear, nose and throat . ere is usually a free discharge ofmuco-pus and a cessation of pain,Paracentesis-knife. especially after prompt spontaneous opening of the membrane. If thishas not occurred and paracentesis has been obligatory, the inspissatedsecretions escape more slowly at first and the pain gradually any form of perforation of the membrana in acute otitis mediaa discharge must be regarded as beneficial, as it carries off pathogenicgerms. Therefore little or no local treatment of the ear should be ap-plied for fear of secondary irritation of the outer ear and perforationof the membrana. If this latter condition is established, the escape ofsecretion from the middle ear is prevented, secondary infection of thiscavity ensues, and chronicity of the purulency is imminent with mastoidcomplications. Hence the outflow of pus from the acutely inflamed earmust be favored. The ear should not be syringed at all at such a time,unless the discharge is very thick and not escaping readily. In acute. cases, for reasons already the time to syringe the ear is before discharge sets in, and not afterwards, for fear of secondary irritation ofthe perforated membrana and infection of the drum-cavity (page 161).In any case of acute purulent discharge, once in twenty-four hours is ACUTE PURULENT OTITIS MEDIA. 163 quite often enough to syringe the ear, if, indeed, it is ever the ear run and drain itself through the natural drainage-tube, theexternal auditory canal. Keep the concha and meatus greased with cos-moline to prevent chapping, and mop with sterilized cotton or gauze asthey become filled with secretions, but do not swab them. At the sametime all forms of inflation, aspiration, and syringing of the nares andnasopharynx must be avoided. Under these conservative and rationalprocedures the ear will, in most instances, return to its normal conditionin the course of two or three weeks. I have never seen acute mastoiditis
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